01. Acrodermatitis

Acrodermatitis is a childhood skin condition that may be accompanied by
mild symptoms of fever and malaise. It may also be associated with
hepatitis B and other viral infections.

Causes

The cause of acrodermatitis is poorly understood, but its link with other infections is well-documented.
In Italian children, acrodermatitis is seen frequently with hepatitis B,
but this link is rarely seen in the United States. Epstein-Barr virus
(EBV, mononucleosis) is the virus most often associated with
acrodermatitis. Other associated viruses include cytomegalovirus,
coxsackie viruses, parainfluenza virus, respiratory syncytial virus
(RSV), and some live virus vaccines.
A rare, genetic form of acrodermatitis is acrodermatitis enteropathica.
In this disorder, zinc is poorly absorbed from the diet. Adding zinc
supplements to the diet improves the condition. This form of the
disorder can be associated with other abnormalities and development
delays.

Symptoms

• Rash or patch on skin
• Brownish-red or copper-colored patch that is firm and flat on top
• String of bumps may appear in a line
• Generally not itchy
• Rash looks the same on both sides of the body
• Rash may appear on the palms and soles -- it does not occur on the
back, chest, or belly area (this is one of the ways it is identified --
by the absence of the rash from the trunk of the body)
Other symptoms that may appear include:
• Swollen abdomen
• Swollen lymph nodes
• Tender lymph nodes

Exams and Tests

Your doctor can diagnose this condition by looking at the skin and rash. The liver, spleen, and lymph nodes may be swollen.
The following tests may be done to confirm the diagnosis or rule out other conditions:
• Bilirubin level
• Hepatitis virus serology or hepatitis B surface antigen
• Liver enzymes (liver function tests)
• Screening for EBV antibodies
• Serum zinc level may be tested in acrodermatitis enteropathica
• Skin biopsy

Treatment

Acrodermatitis by itself is not treated. Infections associated with this
condition, such as hepatitis B and Epstein-Barr, are treated. Cortisone
creams may help with itching and irritation.
Acrodermatitis enteropathica improves when the zinc levels in the body is returned to normal.

Outlook (Prognosis)

Acrodermatitis usually disappears on its own without treatment or complication. Associated conditions must be watched carefully.

Possible Complications

Complications occur as a result of associated conditions, rather than as a result of acrodermatitis.

When to Contact a Medical Professional

Call your health care provider if your child has signs of this condition.

02. Acrodysostosis

Acrodysostosis is an extremely rare disorder that is present at birth
(congenital). It leads to problems with the bones of the hands, feet,
and nose, and intellectual disability.

Causes

Most people with acrodysostosis have no family history of the disease.
However, sometimes the condition is passed down from parent to child.
Parents with the condition have a 1 in 2 chance of passing the disorder
to their children.
There is a slightly greater risk with fathers who are older.

Exams and Tests

Your health care provider can usually diagnose this condition with a physical exam. This may show:
• Advanced bone age
• Bone deformities in hands and feet
• Delays in growth
• Problems with the skin, genitals, teeth, and skeleton
• Short arms and legs with small hands and feet
• Short head, measured front to back
• Short height
• Small, upturned broad nose with flat bridge
• Unusual features of the face (short nose, open mouth, jaw that sticks out)
• Unusual head
• Wide-spaced eyes, sometimes with extra skin fold at corner of eye
In the first months of life, x-rays may show spotty calcium deposits,
called stippling, in bones (especially the nose). Infants may also have:
• Abnormally short fingers and toes
• Early growth of bones in the hands and feet
• Short bones
• Shortening of the forearm bones near the wrist
Two genes have been linked with this condition, and genetic testing may be done.

Treatment

Treatment depends on the symptoms.
Orthopedic care, early intervention, and special education are recommended.

Outlook (Prognosis)

Problems depend on the degree of skeletal involvement and intellectual disability. In general, people do relatively well.

Alternative Names

References

03. Acromegaly

Acromegaly is a condition in which there is too much growth hormone in the body.

Causes

Acromegaly is a rare condition. It is caused when the pituitary gland
makes too much growth hormone. The pituitary gland is a pea-sized
endocrine gland located at the base of the brain. It controls, makes,
and releases several hormones, including growth hormone.
Usually a noncancerous (benign) tumor of the pituitary gland causes the gland to release too much growth hormone.
In children, too much growth hormone causes gigantism rather than acromegaly.

Treatment

Surgery to remove the pituitary tumor that is causing this condition
often corrects the abnormal growth hormone. Sometimes the tumor is too
large to remove completely. People who do not respond to surgery may
have radiation of the pituitary gland.
Medications are used after surgery. Some patients are treated with medicines instead of surgery.
After treatment, you will need to see your health care provider
regularly to make sure that the pituitary gland is working normally.
Yearly evaluations are recommended.

Outlook (Prognosis)

Pituitary surgery is successful in most patients, depending on the size of the tumor and the experience of the surgeon.
Without treatment, the symptoms will get worse. Conditions such as high blood pressure, diabetes, and heart disease may result.

When to Contact a Medical Professional

Call your health care provider if:
• You have symptoms of acromegaly
• Your symptoms do not improve with treatment

Prevention

Acromegaly cannot be prevented. Early treatment may prevent complications of the disease from getting worse.

04. ACTH (cosyntropin) stimulation test

The ACTH stimulation test measures how well the adrenal glands respond
to adrenocorticotropic hormone (ACTH). ACTH is a hormone produced in the
pituitary gland that stimulates the adrenal glands to release a hormone
called cortisol. The man-made form of ACTH is called cosyntropin.

How the Test is Performed

The test is done the following way:
• Your blood is drawn.
• The lab then checks the cortisol level in the blood sample.
• You then receive a shot (injection) of cosyntropin.
• After either 30 minutes or 60 minutes, depending on how much cosyntropin you receive, your blood is drawn again.
• The lab rechecks the cortisol level in the second blood sample.
Along with the blood tests, you may also have a urine cortisol test or
urine 17-ketosteroids test, which involves collecting the urine over a
24-hour period.

How to Prepare for the Test

You may need to limit activities and eat foods that are high in
carbohydrates 12 to 24 hours before the test. You may be asked to fast
for 6 hours before the test. Sometimes, no special preparation is
needed.

How the Test will Feel

When the needle is inserted to draw blood, some people feel moderate
pain. Others feel only a prick or stinging. Afterward, there may be some
throbbing or slight bruising. This soon goes away.

Why the Test is Performed

This test can help determine whether your adrenal and pituitary glands
are normal. It is most often used when the doctor thinks you have an
adrenal gland problem, such as Addison disease or pituitary
insufficiency.

Normal Results

An increase in cortisol after stimulation by ACTH is normal. Cortisol
level after ACTH stimulation should be higher than 18 to 20 micrograms
per deciliter (mcg/dL), depending on the dose of cosyntropin used.
Normal value ranges may vary slightly among different laboratories. Some
labs use different measurements or may test different specimens. Talk
to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

This test is helpful in finding out if you have:
• Acute adrenal crisis
• Addison disease (adrenal glands do not produce enough cortisol)
• Hypopituitarism (pituitary gland is not producing enough hormones such as ACTH)
• Pituitary tumor

Risks

Veins and arteries vary in size from one patient to another and from one
side of the body to the other. Obtaining a blood sample from some
people may be more difficult than from others.
Other risks associated with having blood drawn are slight but may include:
• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

05. ACTH blood test

The ACTH test measures the level of adrenocorticotropic hormone (ACTH)
in the blood. ACTH is a hormone released from the pituitary gland in the
brain.

How the Test is Performed

A blood sample is needed.

How to Prepare for the Test

Your doctor will likely ask you to have the test be done early in the
morning. This is important, because cortisol level varies throughout the
day.
You may also be told to stop taking medicines that can affect the test
results. These medicines include glucocorticoids such as prednisone,
hydrocortisone, or dexamethasone.

How the Test will Feel

When the needle is inserted to draw blood, some people feel moderate
pain. Others feel only a prick or stinging. Afterward, there may be some
throbbing or slight bruising. This soon goes away.

Why the Test is Performed

The main function of ACTH is to regulate the steroid hormone cortisol.
Cortisol is released by the adrenal gland. It regulates blood pressure
and blood sugar.
This test can help find the causes of certain hormone problems.

Normal Results

Normal values for a blood sample taken early in the morning are 9 to 52 picograms per milliliter (pg/mL).
Normal value ranges may vary slightly among different laboratories. Some
labs use different measurements or may test different specimens. Talk
to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

A higher-than-normal level of ACTH may indicate:
• Adrenal glands not producing enough cortisol (Addison disease)
• Adrenal glands not producing enough hormones (congenital adrenal hyperplasia)
• One or more of the endocrine glands are overactive or have formed a tumor (multiple endocrine neoplasia type I)
• Pituitary is making too much ACTH (Cushing disease), which is usually caused by a non-cancerous tumor of the pituitary gland
• Rare type of tumor (lung, thyroid, or pancreas) making too much ACTH (ectopic Cushing syndrome)
A lower-than-normal level of ACTH may indicate:
• Pituitary gland not producing enough hormones, such as ACTH (hypopituitarism)
• Tumor of the adrenal gland that produces too much cortisol
• Glucocorticoid medicines are suppressing ACTH production
Other conditions under which the test may be performed:
• Multiple endocrine neoplasia (MEN) I

Risks

Veins and arteries vary in size from one patient to another and from one
side of the body to the other. Obtaining a blood sample from some
people may be more difficult than from others.
Other risks associated with having blood drawn are slight but may include:
• Excessive bleeding
• Fainting or feeling lightheaded
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

06. Actinic keratosis

Actinic keratosis is a small, rough, raised area found on areas of your
skin that have often been exposed to the sun for a long period of time.
Some actinic keratoses may develop into a type of skin cancer.

Causes

Actinic keratosis is caused by exposure to sunlight.
You are more likely to develop this if you:
• Have fair skin, blue or green eyes, or blond or red hair
• Had a kidney or other transplant
• Take medicines that suppress the immune system
• Spend a lot of time each day in the sun (for example, if you work outdoors)
• Had many, severe sunburns early in life
• Are older

Symptoms

Actinic keratosis is usually found on the face, scalp, back of the hands, chest, or places that are often in the sun.
• The skin changes begin as flat and scaly areas. They often have a white or yellow crusty "scale" on top.
• The growths may be gray, pink, red, or the same color as the skin.
Later they may become hard and wart-like or gritty and rough.
• The areas may be easier to feel than see.

Exams and Tests

Your doctor or nurse will look at your skin to diagnose this condition. A skin biopsy may be done to see if it is cancer.

Treatment

Some actinic keratoses become squamous cell skin cancer. Have all skin
growths looked at by a doctor as soon as you find them. Your doctor will
tell you how to treat it.
Growths may be removed by:
• Burning (electrical cautery)
• Scraping away the lesion and using electricity to kill any remaining cells (called curettage and electrodesiccation)
• Cutting the tumor out and using stitches to place the skin back together (called excision)
• Freezing (cryotherapy, which freezes and kills the cells)
If you have many of these skin growths, your doctor may recommend:
• A laser treatment called photodynamic therapy
• Chemical peels
• Skin creams such as 5-fluorouracil (5-FU) and imiquimod

Outlook (Prognosis)

A small number of these skin growths turn a type of skin cancer called squamous cell carcinoma.

When to Contact a Medical Professional

Call your health care provider if you see or feel a rough or scaly spot on your skin, or if you notice any other skin changes.

Prevention

The best way to lower your risk of actinic keratosis and skin cancer is
to learn how to protect your skin from sun and ultraviolet (UV) light.
Things you can do to lower your exposure to sunlight include:
• Wear clothing such as hats, long-sleeved shirts, long skirts, or pants.
• Try to avoid being in the sun during midday, when ultraviolet light is most intense.
• Use high-quality sunscreens, preferably with a sun protection factor
(SPF) rating of at least 15. Pick a sunscreen that blocks both UVA and
UVB light.
• Apply sunscreen before going out into the sun, and reapply often.
• Use sunscreen year-round, including in the winter.
• Avoid sun lamps, tanning beds, and tanning salons.
Other things to know about sun exposure:
• Sun exposure is stronger in or near surfaces that reflect light, such as water, sand, concrete, and areas painted white.
• Sun exposure is more intense at the beginning of the summer.
• Skin burns faster at higher altitudes.

References

07. Actinomycosis

Actinomycosis is a long-term (chronic) bacterial infection that commonly affects the face and neck.

Causes

Actinomycosis is usually caused by bacterium called Actinomyces
israelii. This is a common and organism found in the nose and throat. It
normally does not cause disease.
Because of the bacteria's normal location in the nose and throat,
actinomycosis most commonly affects the face and neck. The infection can
sometimes occur in the chest (pulmonary actinomycosis), abdomen,
pelvis, or other areas of the body. The infection is not contagious.
This means it does not spread to other persons.
Symptoms occur when the bacteria enter the tissues of the face after
trauma, surgery, or infection. Common triggers include dental abscess or
oral surgery. The infection can also affect certain women who have had
an intrauterine device (IUD) to prevent pregnancy.
Once in the tissue, the bacteria causes an abscess, producing a hard,
red to reddish-purple lump, often on the jaw, from which comes the
condition's common name, "lumpy jaw."
Eventually, the abscess breaks through the skin surface to produce a draining sinus tract.

Symptoms

• Draining sores in the skin, especially on the chest wall from lung infection with Actinomyces
• Fever
• Minimal or no pain
• Swelling or a hard, red to reddish-purple lump on the face or upper neck
• Weight loss

Exams and Tests

The health care provider will perform a physical exam and ask questions about your symptoms.
Tests that may be done to check for presence of the bacteria include:
• Culture of the tissue or fluid
• Examination of drained fluid under a microscope

Treatment

Treatment of actinomycosis usually requires antibiotics for several
months to a year. Surgical drainage or removal of the affected area
(lesion) may be needed. If the condition is related to an IUD, the
device must be removed.

08. Acute

Acute means sudden or severe. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.

09. Acute adrenal crisis

Acute adrenal crisis is a life-threatening condition that occurs when
there is not enough cortisol. This is a hormone produced by the adrenal
glands.

Causes

The adrenal glands are located just above the kidneys. The adrenal gland
consists of two parts. The outer portion, called the cortex, produces
cortisol. This is an important hormone for controlling blood pressure.
The inner portion, called the medulla, produces the hormone adrenaline
(also called epinephrine). Both cortisol and adrenaline are released in
response to stress.
Cortisol production is regulated by the pituitary gland. This is a small
gland behind the nose and under the brain. The pituitary gland releases
adrenocorticotropic hormone (ACTH). This is a hormone that causes the
adrenal glands to release cortisol.
Adrenaline production is regulated by nerves coming from the brain and spinal cord and by circulating hormones.
Adrenal crisis occurs when:
• The adrenal gland is damaged due to, for example, Addison disease or other adrenal gland disease, surgery
• The pituitary gland is injured and cannot release ACTH
• Adrenal insufficiency is not properly treated
Risk factors for adrenal crisis include:
• Dehydration
• Infection and other physical stress
• Injury to the adrenal or pituitary gland
• Stopping treatment too suddenly with glucocorticoid medications such as prednisone or hydrocortisone
• Surgery
• Trauma

Exams and Tests

Treatment

In adrenal crisis, patients need an immediate injection of
hydrocortisone through a vein (intravenous) or muscle (intramuscular).
You may receive intravenous fluids if you have low blood pressure.
You will need to go to the hospital for treatment and monitoring. If
infection or another medical problem caused the crisis, you may need
additional treatment.

Outlook (Prognosis)

Shock may occur if treatment is not provided early, and it can be life-threatening.

Possible Complications

• Coma
• Seizures
• Shock
• Hypoglycemia

When to Contact a Medical Professional

Call your health care provider if you have Addison disease and are unable to take your glucocorticoid medicine for any reason.
Go to the emergency room or call the local emergency number (such as 911) if you develop symptoms of acute adrenal crisis.
If you have Addison disease, you may be told to increase the dosage of
your glucocorticoid medicine if you are very ill or before having
surgery.

Prevention

If you have Addison disease, learn to recognize signs of potential
stress that may cause an acute adrenal crisis. If you have been
instructed by your doctor, be prepared to give yourself an emergency
shot of glucocorticoid or to increase your dosage of oral glucocorticoid
medication in times of stress.
Always carry medical ID (card, bracelet, or necklace) that says you have
adrenal insufficiency. The ID should also say the type of medicine and
dosage you need in case of an emergency.
Never miss taking your medicines.

10. Acute arterial occlusion - kidney

Acute arterial occlusion of the kidney is a sudden, severe blockage of the artery that supplies blood to the kidney.

Causes

The kidneys need a good blood supply. The main artery to the kidney is
called the renal artery. Reduced blood flow through the renal artery can
hurt kidney function. A complete blockage of blood flow to the kidney
can often result in permanent kidney failure.
Acute arterial occlusion of the renal artery can occur after injury or
trauma to the abdomen, side, or back. Blood clots that travel through
the bloodstream (emboli) can lodge in the renal artery. Pieces of plaque
from the walls of the arteries can come loose (on their own or during a
procedure). This debris can block the main kidney artery one or one of
the smaller vessels.
The risk of renal artery blockages increases in people who have certain
heart disorders which make them likely to form blood clots. These
include mitral stenosis and atrial fibrillation.
A narrowing of the renal artery is called renal artery stenosis. This condition increases the risk of a sudden blockage.

Symptoms

You may not have symptoms when one kidney does not function because the
second kidney can filter the blood. However, high blood pressure
(hypertension) may come on suddenly and be difficult to control.
If your other kidney is not working fully, blockage of the renal artery
may cause symptoms of acute kidney failure. Other symptoms of acute
arterial occlusion of the renal artery include:
• Abdominal pain
• Abrupt decrease in urine output
• Back pain
• Blood in the urine
• Flank pain or pain in the side
• Symptoms of high blood pressure such as headache, change in vision, and swelling
Note: There may be no pain. Pain, if it is present, usually develops suddenly.

Exams and Tests

The doctor will not be able to identify the problem with just an exam unless you have developed kidney failure.
Tests you may need include:
• Duplex Doppler ultrasound exam of the renal arteries to test blood flow
• MRI of the kidney arteries, which can show a lack of blood flow to the affected kidney
• Renal arteriography shows the exact location of the blockage
• Renal nuclear scan shows a lack of blood flow to the affected kidney
• Ultrasound of the kidney to check kidney size

Treatment

Often, patients do not need treatment. Blood clots may get better on their own over time.
You may have treatment to open the artery if the blockage is discovered
quickly or it is affecting the only working kidney. Treatment to open
the artery may include:
• Clot-dissolving medicines (thrombolytics)
• Medicines that prevent the blood from clotting (anticoagulants), such as warfarin (Coumadin)
• Surgical repair of the renal artery
• Insertion of a tube (catheter) into the renal artery to open the blockage
You may need temporary dialysis to treat acute kidney failure. Medicines
to lower cholesterol may be needed if the blockage is due to clots from
plaque buildup in the arteries.

Outlook (Prognosis)

Damage caused by arterial occlusion may go away. However, in most cases it is permanent.
If only one kidney is affected, the healthy kidney may take over
filtering the blood and producing urine. If you have only one working
kidney, arterial occlusion leads to acute kidney failure. This can
develop into chronic kidney failure.

Possible Complications

When to Contact a Medical Professional

Call your health care provider if:
• You stop producing urine
• You feel sudden, severe pain in the back, flank, or abdomen.
Get emergency medical help right away if you have symptoms of arterial occlusion and have only one working kidney.

Prevention

In many cases, the disorder is not preventable. The most important way to reduce your risk is to stop smoking.
People at risk for developing blood clots may need to take anti-clotting
medicines. Taking steps to control diseases related to atherosclerosis
(hardening of the arteries) may reduce your risk.

11. Acute cerebellar ataxia

Acute cerebellar ataxia is sudden, uncoordinated muscle movement due to disease or injury to the cerebellum in the brain.

Causes

Acute cerebellar ataxia in children, especially younger than age 3, may occur several weeks after an illness caused by a virus.
Viral infections that may cause this include chickenpox, Coxsackie disease, Epstein-Barr, and echovirus.
Other causes of acute cerebellar ataxia include:
• Abscess of the cerebellum
• Alcohol, medications, and insecticides
• Bleeding into the cerebellum
• Multiple sclerosis
• Strokes of the cerebellum
• Vaccination

Symptoms

Ataxia may affect movement of the middle part of the body from the neck
to the hip area (the trunk) or the arms and legs (limbs).
When the person is sitting, the body may move side-to-side,
back-to-front, or both. Then the body quickly moves back to an upright
position.
When a person with ataxia of the arms reaches for an object, the hand may sway back and forth.
Common symptoms of ataxia include:
• Clumsy speech pattern (dysarthria)
• Repetitive eye movements (nystagmus)
• Uncoordinated eye movements
• Walking problems (unsteady gait)

Exams and Tests

The doctor will ask if the person has recently been sick and will try to
rule out any other causes of the problem. Brain and nervous system
examination will be done to identify the areas of the nervous system
that are most affected.
The following tests may be ordered:
• CT scan of the head
• MRI scan of the head
• Spinal tap

Treatment

Treatment depends on the cause:
• If the acute cerebellar ataxia is due to bleeding, surgery may be needed.
• For a stroke, medicine to thin the blood can be given.
• Infections may need to be treated with antibiotics or antivirals.
• Steroids may be needed for swelling (inflammation) of the cerebellum (such as from multiple sclerosis)
• Cerebellar ataxia caused by a recent viral infection may not need treatment.

Outlook (Prognosis)

People whose condition was caused by a recent viral infection should
make a full recovery without treatment in a few months. Strokes,
bleeding, or infections may cause permanent symptoms.

12. Acute cholecystitis

Acute cholecystitis is a sudden swelling and irritation of the gallbladder. It causes severe belly pain.
See also: Chronic cholecystitis

Causes

The gallbladder is an organ that sits below the liver. It stores bile,
which your body uses to digest fats in the small intestine.
Acute cholecystitis occurs when bile becomes trapped in the gallbladder.
This often happens because a gallstone blocks the cystic duct. This is
the tube that bile travels into and out of the gallbladder. When a stone
blocks this duct, bile builds up, causing irritation and pressure in
the gallbladder. This can lead to swelling and infection.
Other causes include:
• Serious illnesses such as HIV or diabetes
• Tumors of the gallbladder (rare)
Some people are more at risk for gallstones. Risk factors include:
• Being female
• Pregnancy
• Hormone therapy
• Older age
• Being Native American or Hispanic
• Obesity
• Losing or gaining weight rapidly
• Diabetes
Sometimes the bile duct becomes blocked temporarily. When this occurs
repeatedly, it can lead to chronic cholecystitis. This is swelling and
irritation that continues over time. Eventually, the gallbladder becomes
thick and hard. It also does not store and release bile as well.

Symptoms

The main symptom is pain in the upper right side or upper middle of your
belly that usually lasts at least 30 minutes. You may feel:
• Sharp, cramping, or dull pain
• Steady pain
• Pain that spreads to your back or below your right shoulder blade
Other symptoms that may occur include:
• Clay-colored stools
• Fever
• Nausea and vomiting
• Yellowing of skin and whites of the eyes (jaundice)

Exams and Tests

A physical exam will show that it hurts to touch your belly.
Your doctor may order the following blood tests:
• Amylase and lipase
• Bilirubin
• Complete blood count (CBC)
• Liver function tests
Imaging tests can show gallstones or inflammation. You may have one of these tests:
• Abdominal ultrasound
• Abdominal CT scan
• Abdominal x-ray
• Oral cholecystogram
• Gallbladder radionuclide scan

Treatment

If you have severe belly pain, seek medical attention right away.
In the emergency room, you'll be given fluids through a vein. You also may be given antibiotics to fight infection.
Cholecystitis may clear up on its own. However, if you have gallstones,
you will probably need surgery to remove your gallbladder.
Nonsurgical treatment includes:
• Antibiotics to fight infection
• Low-fat diet (if you are able to eat)
• Pain medicines
You may need emergency surgery if you have complications such as:
• Gangrene (tissue death)
• Perforation (a hole that forms in the wall of the gallbladder)
• Pancreatitis (inflamed pancreas)
• Persistent bile duct blockage
• Inflammation of the common bile duct
If you are very ill, a tube may be placed in your gallbladder and
through your skin to drain it. Then, once you are feeling better, you
may have surgery.

Outlook (Prognosis)

Most people who have surgery to remove their gallbladder recover completely.

13. Acute cytomegalovirus (CMV) infection

Acute cytomegalovirus (CMV) infection is a condition caused by a member of the herpesvirus family.

Causes

Infection with cytomegalovirus (CMV) is very common. The infection is spread by:
• Blood transfusions
• Organ transplants
• Respiratory droplets
• Saliva
• Sexual contact
• Urine
Most people come into contact with CMV in their lifetime. Typically only
people with a weakened immune system become ill from CMV infection.
Some otherwise healthy people with acute CMV infection develop a
mononucleosis-like syndrome.
In the United States, CMV infection most commonly develops between ages
10 and 35. Many people are exposed to CMV early in life but do not
realize it because they have no symptoms, or they have mild symptoms
that resemble the common cold. People with a compromised immune system
can have a more severe form of the disease.
CMV is a type of herpes virus. The virus remains in your body for the
rest of your life. If your immune system becomes weakened in the future,
this virus may have the chance to reactivate, causing symptoms.

Exams and Tests

Your health care provider will perform a physical exam and feel your
belly area. Your liver and spleen may be tender when they are gently
pressed (palpated). You may have a skin rash.
Special lab tests such as a CMV DNA serum PCR test may be done to check
for substances in your blood that are produced by CMV. Other tests such
as a CMV antibody test may be done to check your body’s response to the
CMV infection.
Other tests include:
• Blood tests for platelets and white blood cells
• Chemistry panel
• Liver function tests
• Monospot test

Treatment

Most patients recover in 4 to 6 weeks without medication. Rest is
needed, sometimes for a month or longer to regain full activity levels.
Painkillers and warm salt-water gargles can help relieve symptoms.
Antiviral medications are usually not used in people with normal immune function.

Outlook (Prognosis)

Fever usually goes away in 10 days, and swollen lymph glands and spleen
return to normal in 4 weeks. Fatigue may linger for 2 to 3 months.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have symptoms of acute CMV infection.
Go to the emergency room or call the local emergency number (such as
911) if you have sharp, severe sudden pain in your left upper abdomen.
This could be a sign of a ruptured spleen, which may require emergency
surgery.

Prevention

CMV infection can be contagious if the infected person comes in close or
intimate contact with another person. You should avoid kissing and
sexual contact with an infected person.
The virus may also spread among young children in day care settings.
When planning blood transfusions or organ transplants, the CMV status of
the donor can be checked to avoid passing CMV to a recipient who has
not had CMV infection.

Symptoms

Symptoms of acute kidney failure may include any of the following:
• Bloody stools
• Breath odor and metallic taste in the mouth
• Bruising easily
• Changes in mental status or mood
• Decreased appetite
• Decreased sensation, especially in the hands or feet
• Fatigue
• Flank pain (between the ribs and hips)
• Hand tremor
• High blood pressure
• Nausea or vomiting, may last for days
• Nosebleeds
• Persistent hiccups
• Prolonged bleeding
• Seizures
• Shortness of breath
• Slow, sluggish movements
• Swelling due to the body keeping in fluid (may be seen in the legs, ankles, and feet)
• Urination changes, such as little or no urine, excessive urination at night, or urination that stops completely

Exams and Tests

The doctor or nurse will examine you. Many patients with kidney disease
have body swelling caused by fluid retention. The doctor may hear a
heart murmur, crackles in the lungs, or other abnormal sounds when
listening to the heart and lungs with a stethoscope.
The results of laboratory tests may change suddenly (within a few days to 2 weeks). Such tests may include:
• BUN
• Creatinine clearance
• Serum creatinine
• Serum potassium
• Urinalysis
A kidney or abdominal ultrasound is the preferred test for diagnosing a
blockage in the urinary tract. X-ray, CT scan, or MRI of the abdomen can
also tell if there is a blockage.
Blood tests may help reveal the underlying cause of kidney failure.
Arterial blood gas and blood chemistries may show metabolic acidosis.

Treatment

Once the cause is found, the goal of treatment is to help your kidneys
work again and prevent fluid and waste from building up in your body
while they heal. Usually, you will have to stay overnight in the
hospital for treatment.
The amount of liquid you drink will be limited to the amount of urine
you can produce. You will be told what you may and may not eat to reduce
the buildup of toxins that the kidneys would normally remove. Your diet
may need to be high in carbohydrates and low in protein, salt, and
potassium.
You may need antibiotics to treat or prevent infection. Diuretics (water pills) may be used to help remove fluid from your body.
Medicines will be given through a vein to help control your blood potassium level.
You may need dialysis. This is a treatment that does what healthy
kidneys normally do -- rid the body of harmful wastes, extra salt, and
water. Dialysis can save your life if your potassium levels are
dangerously high. Dialysis will also be used if:
• Your mental status changes
• You stop urinating
• You develop pericarditis
• You retain too much fluid
• You cannot remove nitrogen waste products from your body
Dialysis will most often be short term. In rare cases, the kidney damage is so great that dialysis is needed permanently.

When to Contact a Medical Professional

Call your health care provider if your urine output slows or stops or you have other symptoms of acute kidney failure.

Prevention

Treating disorders such as high blood pressure can help prevent acute kidney failure.

15. Acute lymphoblastic leukemia (ALL)

Acute lymphoblastic leukemia (ALL) is a fast-growing cancer of a type of white blood cell called a lymphoblast.
ALL occurs when the bone marrow produces a large number of immature
lymphoblasts. Bone marrow is the soft tissue in the center of bones that
helps form all blood cells. The abnormal lymphoblasts grow quickly and
replace normal cells in the bone marrow. ALL prevents healthy blood
cells from being made. Life-threatening symptoms can occur as normal
blood counts drop.

Causes

Most of the time, no clear cause can be found for ALL.
The following factors may play a role in the development of all types of leukemia:
• Certain chromosome problems
• Exposure to radiation, including x-rays before birth
• Past treatment with chemotherapy drugs
• Receiving a bone marrow transplant
• Toxins, such as benzene
The following factors are known to increase the risk of ALL:
• Down syndrome or other genetic disorders
• A brother or sister with leukemia
This type of leukemia usually affects children ages 3 to 7. ALL is the
most common childhood cancer, but it can also occur in adults.

Symptoms

ALL makes a person more likely to bleed and develop infections. Symptoms include:
• Bone and joint pain
• Easy bruising and bleeding (such as bleeding gums, skin bleeding, nosebleeds, abnormal periods)
• Feeling weak or tired
• Fever
• Loss of appetite and weight loss
• Paleness
• Pain or feeling of fullness below the ribs
• Pinpoint red spots on the skin (petechiae)
• Swollen glands (lymphadenopathy) in the neck, under arms, and groin
• Night sweats
These symptoms can occur with other conditions. Talk to the doctor about the meaning of specific symptoms.

Treatment

The first goal of treatment is to get blood counts back to normal. If
this occurs and the bone marrow looks healthy under the microscope, the
cancer is said to be in remission.
Chemotherapy is the first treatment tried with the goal of achieving a remission.
• The person may need to stay in the hospital for chemotherapy. Or it
can be given at a clinic and the patient goes home afterward.
• Chemotherapy is given into the veins (by IV) and sometimes into the fluid around the brain (the spinal fluid).
After a remission is achieved, more treatment is given to achieve a
cure. This treatment can include more IV chemotherapy or radiation to
the brain. Stem cell or bone marrow transplant from another person may
also be done. Further treatment depends on:
• Age and health of the person
• Genetic changes in the leukemia cells
• How many courses of chemotherapy it took to achieve remission
• If abnormal cells are still detected under the microscope
• Availability of donors for stem cell transplant

Support Groups

You can ease the stress of illness by joining a cancer support group.
Sharing with others who have common experiences and problems can help
you not feel alone.

Outlook (Prognosis)

Those who respond to treatment right away tend to do better. Most
children with ALL can be cured. Children often have a better outcome
than adults.

Possible Complications

Both leukemia itself and the treatment can lead to many problems such as bleeding, weight loss, and infections.

16. Acute mountain sickness

Acute mountain sickness is an illness that can affect mountain climbers,
hikers, skiers, or travelers at high altitudes, usually above 8,000
feet (2,400 meters).

Causes

Acute mountain sickness is caused by reduced air pressure and lower oxygen levels at high altitudes.
The faster you climb to a high altitude, the more likely you will get acute mountain sickness.
You are at higher risk for acute mountain sickness if:
• You live at or near sea level and travel to a high altitude
• You have had the illness before

Symptoms

Your symptoms will also depend on the speed of your climb and how hard
you push (exert) yourself. Symptoms range from mild to life-threatening.
They can affect the nervous system, lungs, muscles, and heart.
In most cases, symptoms are mild. Symptoms of mild to moderate acute mountain sickness may include:
• Difficulty sleeping
• Dizziness or light-headedness
• Fatigue
• Headache
• Loss of appetite
• Nausea or vomiting
• Rapid pulse (heart rate)
• Shortness of breath with exertion
Symptoms that may occur with more severe acute mountain sickness include:
• Blue color to the skin (cyanosis)
• Chest tightness or congestion
• Confusion
• Cough
• Coughing up blood
• Decreased consciousness or withdrawal from social interaction
• Gray or pale complexion
• Cannot walk in a straight line, or walk at all
• Shortness of breath at rest

Exams and Tests

The doctor or nurse will examine you and listen to your chest with a
stethoscope. This may reveal sounds called crackles (rales) in the lung.
Rales may be a sign of fluid in the lungs.
Tests that may be done include:
• Blood tests
• Brain CT scan
• Chest x-ray
• Electrocardiogram (ECG)

Treatment

Early diagnosis is important. Acute mountain sickness is easier to treat in the early stages.
The main treatment for all forms of mountain sickness is to climb down
(descend) to a lower altitude as rapidly and safely as possible. You
should not continue climbing if you develop symptoms.
Extra oxygen should be given, if available.
People with severe mountain sickness may need to be admitted to a hospital.
Acetazolamide (Diamox) may be given to help you breathe better. It can
help reduce mild symptoms. This medicine can make you urinate more
often. Make sure you drink plenty of fluids and avoid alcohol when
taking this drug. This medication works best when taken before reaching a
high altitude.
If you have fluid in your lungs (pulmonary edema), treatment may include:
• Oxygen
• A high blood pressure medicine called nifedipine
• Beta agonist inhalers to open the airways
• Breathing machine in severe cases
• Medicine to increase blood flow to the lungs called phosphodiesterase inhibitor (such as sildenafil)
Dexamethasone (Decadron) may help reduce swelling in the brain (cerebral edema).
Portable hyperbaric chambers allow hikers to simulate conditions at
lower altitudes without actually moving from their location on the
mountain. These devices are very helpful if bad weather or other factors
make climbing down the mountain impossible.

Outlook (Prognosis)

Most cases are mild. Symptoms improve quickly when you climb down the mountain to a lower altitude.
Severe cases may result in death due to lung problems or brain swelling, called cerebral edema.
In remote locations, emergency evacuation may not be possible, or
treatment may be delayed. This can have a negative affect on your
outcome.

Possible Complications

• Coma
• Fluid in the lungs (pulmonary edema)
• Swelling of the brain (cerebral edema), which can lead to seizures, mental changes, or permanent damage to the nervous system

When to Contact a Medical Professional

Call your health care provider if you have or had symptoms of acute
mountain sickness, even if you felt better when you returned to a lower
altitude.
Call 911 or your local emergency number if you or another climber have any of the following symptoms:
• Severe breathing problems
• Altered level of alertness
• Coughing up blood
Climb down the mountain immediately and as safely as possible.

Prevention

Keys to preventing acute mountain sickness include:
• Climb the mountain gradually
• Stop for a day or two of rest for every 2,000 feet (600 meters) above 8,000 feet (2,400 meters)
• Sleep at a lower altitude when possible
• Learn how to recognize early symptoms of mountain sickness
If you are traveling above 9,840 feet (3,000 meters), you should carry enough oxygen for several days.
If you plan on quickly climbing to a high altitude, ask your doctor
about a medication called acetazolamide (Diamox). This drug helps your
body get used to higher altitudes more quickly, and reduces minor
symptoms. It should be taken the day before you climb, and then for the
next 1 to 2 days.
If you are at risk for a low red blood cell count (anemia), ask your
doctor if an iron supplement is right for you. Anemia lowers the amount
of oxygen in your blood. This makes you more likely to have mountain
sickness.
While climbing:
• Drink plenty of fluids
• Avoid alcohol
• Eat regular meals, high in carbohydrates
You should avoid high altitudes if you have heart or lung disease.

17. Acute myeloid leukemia

Acute myeloid leukemia (AML) is cancer that starts inside bone marrow.
This is the soft tissue in the center of bones that helps form all blood
cells. The cancer grows from cells that would normally turn into white
blood cells.
Acute means the disease develops quickly and usually has an aggressive course.

Causes

Acute myeloid leukemia (AML) is one of the most common types of leukemia
among adults. This type of cancer is rare under age 40.
AML is more common in men than women.
Persons with this type of cancer have an abundance of abnormal immature
cells inside their bone marrow. The cells grow very quickly, and replace
healthy blood cells. The bone marrow, which helps the body fight
infections and makes other blood components, eventually stops working
correctly. Persons with AML are more likely to have infections and have
an increased risk of bleeding as the numbers of healthy blood cells
decrease.
Most of the time, a doctor cannot tell you what caused AML. However, the
following things can lead to some types of leukemia, including AML:
• Blood disorders, including polycythemia vera, thrombocythemia, and myelodysplasia
• Certain chemicals (for example, benzene)
• Certain chemotherapy drugs, including etoposide and drugs known as alkylating agents
• Exposure to certain chemicals and harmful substances
• Radiation
• Weakened immune system due to an organ transplant
Problems with your genes may also play a role in the development of AML.

Exams and Tests

The doctor will perform a physical exam. There may be signs of a swollen spleen, liver, or lymph nodes.
A complete blood count (CBC) may show anemia and a low number of
platelets. A white blood cell count (WBC) can be high, low, or normal.
Bone marrow aspiration and biopsy will show if there are any leukemia cells.
If your doctor learns you do have this type of leukemia, further tests
will be done to determine the specific type of AML. Subtypes are based
on specific genetic changes or mutations and how the leukemia cells
appear under the microscope.

Treatment

Treatment involves using medicines (chemotherapy) to kill the cancer
cells. Most types of AML are treated the same way in the beginning, with
more than one chemotherapy drug.
Chemotherapy kills normal cells, too. This may cause side effects such as:
• Increased risk of bleeding
• Increased risk of infection (your doctor may want to keep you away from other people to prevent infection)
• Weight loss (you will need to eat extra calories)
• Mouth sores
Other supportive treatments for AML may include:
• Antibiotics to treat infection
• Red blood cell transfusions to fight anemia
• Transfusions of platelets to control bleeding
A bone marrow (stem cell) transplant will likely be done after your
first or second round of chemotherapy. This decision is determined by
several factors, including:
• Your age and overall health
• How high your white blood cell count was
• Certain genetic changes in the leukemia cells
• The availability of donors

Support Groups

You can ease the stress of illness by joining a cancer support group.
Sharing with others who have common experiences and problems can help
you not feel alone.

Outlook (Prognosis)

When a bone marrow biopsy shows no evidence of AML, you are said to be
in remission. Complete remission occurs in most patients. How well you
do depends on your overall health and the genetic subtype of the AML
cells.
Remission is not the same as a cure. More therapy is usually needed,
either in the form of more chemotherapy or a bone marrow transplant.
With treatment, younger patients with AML tend to do better than those
who develop the disease at an older age. The 5-year survival rate is
much lower in older adults than younger persons. Experts say this is
partly due to the fact that younger people are better able to tolerate
strong chemotherapy medicines. Also, leukemia in older people tends to
be more resistant to current treatments.
If the cancer does not come back (relapse) within 5 years of the diagnosis, you are likely cured.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you develop symptoms of AML.
Call your health care provider if you have AML and have a fever that will not go away or other signs of infection.

Prevention

If you work around radiation or chemicals linked to leukemia, you should always wear protective gear.

18. Acute nephritic syndrome

Acute nephritic syndrome is a group of symptoms that occur with some
disorders that cause glomerulonephritis, or swelling and inflammation of
the glomeruli in the kidney.

Causes

Acute nephritic syndrome is often caused by an immune response triggered by an infection or other disease.
Common causes in children and adolescents include:
• Hemolytic uremic syndrome
• Henoch-Schonlein purpura
• IgA nephropathy
• Post-streptococcal glomerulonephritis
Common causes in adults include:
• Abdominal abscesses
• Goodpasture syndrome
• Hepatitis B or C
• Infective endocarditis
• Membranoproliferative GN I
• Membranoproliferative GN II
• Rapidly progressive (crescentic) glomerulonephritis
• SLE or lupus nephritis
• Vasculitis
• Viral diseases such as mononucleosis, measles, mumps
The inflammation affects the function of the glomerulus -- the part of
the kidney that filters blood to make urine and remove waste. As a
result, blood and protein appear in the urine, and excess fluid builds
up in the body.
Swelling of the body occurs when the blood loses a protein called
albumin. (Albumin keeps fluid in the blood vessels. When it is lost,
fluid collects in the body tissues). Blood loss from the damaged kidney
structures leads to blood in the urine.
Acute nephritic syndrome may be related to:
• Acute kidney failure
• High blood pressure

Treatment

The goal of treatment is to reduce inflammation in the kidney and
control high blood pressure. You may need to stay in a hospital to be
diagnosed and treated. Treatment may include antibiotics or other
medications or therapies.
Your doctor may recommend bedrest. You may need to limit salt, fluids,
and potassium in your diet. Your health care provider may prescribe
medications to control high blood pressure. Corticosteroids or other
anti-inflammatory medications may be used to reduce inflammation.
You may also need other treatments for acute kidney failure.

Support Groups

For information and support, see kidney disease support groups.

Outlook (Prognosis)

The outlook depends on the disease that is causing the nephritis. When
the condition improves, symptoms of fluid retention (such as swelling
and cough) and high blood pressure may go away in 1 or 2 weeks. However,
urine tests may take months to return to normal.
Children tend to do better than adults and usually recover completely.
Only rarely do they develop complications or progress to chronic
glomerulonephritis and chronic kidney disease.
Adults do not recover as well or as quickly as children. Although it is
unusual for the disease to return, at least one-third of adults whose
disease does return will develop end-stage kidney disease and may need
dialysis or a kidney transplant.

19. Acute pancreatitis

Acute pancreatitis is sudden swelling and inflammation of the pancreas.

Causes

The pancreas is an organ located behind the stomach that produces
chemicals called enzymes, which are needed to digest food. It also
produces the hormones insulin and glucagon. Most of the time, the
enzymes are only active after they reach the small intestine.
When these enzymes become active inside the pancreas, they digest the
tissue of the pancreas. This causes swelling, bleeding (hemorrhage), and
damage to the organ and its blood vessels. This condition is called
acute pancreatitis.
Acute pancreatitis affects men more often than women. Certain diseases,
surgeries, and habits make you more likely to develop this condition.
The two most common causes of pancreatitis in the United States are
heavy alcohol use and gallstones.
Alcohol use is responsible for up to 70% of cases in the United States.
Acute pancreatitis typically requires 5 to 8 drinks per day for 5 or
more years. Gallstones are the next most common cause. The condition
develops when the gallstones travel out of the gallbladder into the bile
ducts, where they block the opening that drains the common bile duct
and pancreatic duct (ampulla). Genetics may be a factor in some cases.
Sometimes, the cause is not known.
Other conditions that have been linked to pancreatitis are:
• Autoimmune problems (when the immune system attacks the body)
• Damage to the ducts or pancreas during surgery
• High blood levels of a fat called triglycerides (hypertriglyceridemia) usually above 1000 mg/dL
• Injury to the pancreas from an accident
Other causes include:
• Complications of cystic fibrosis
• Hemolytic uremic syndrome
• Hyperparathyroidism
• Kawasaki disease
• Reye syndrome
• Use of certain medications (especially estrogens, corticosteroids, sulfonamides, thiazides and azathioprine)
• Viral infections, including mumps, coxsackie B, mycoplasma pneumonia, and campylobacter
• Injury to the pancreas after a procedure such as an ERCP (endoscopic
retrograde cholangiopancreatography) or EUS (endoscopic ultrasound) with
FNA (fine needle aspirate)

Symptoms

The main symptom of pancreatitis is pain felt in the upper left side or middle of the abdomen. The abdominal pain:
• May be worse within minutes after eating or drinking at first, especially if foods have a high fat content
• Becomes constant and more severe, lasting for several days
• May be worse when lying flat on the back
• May spread (radiate) to the back or below the left shoulder blade
People with acute pancreatitis often look ill and have a fever, nausea, vomiting, and sweating.
Other symptoms that may occur with this disease include:
• Clay-colored stools
• Gaseous abdominal fullness
• Hiccups
• Indigestion
• Mild yellowing of the skin and whites of the eyes (jaundice)
• Swollen abdomen

Treatment

Treatment often requires a stay in the hospital. It may involve:
• Pain medicines
• Fluids given through a vein (IV)
• Stopping food or fluid by mouth to limit the activity of the pancreas
A tube may be inserted through the nose or mouth to remove the contents
of the stomach (nasogastric suctioning). This may be done if vomiting
and severe pain do not improve, or if a paralyzed bowel (paralytic
ileus) develops. The tube will stay in for 1 - 2 days to 1 - 2 weeks.
Treating the condition that caused the problem can prevent repeated attacks.
In some cases, therapy is needed to:
• Drain fluid that has collected in or around the pancreas
• Remove gallstones
• Relieve blockages of the pancreatic duct
In the most severe cases, surgery is needed to remove damaged, dead or infected pancreatic tissue.
Avoid smoking, alcoholic drinks, and fatty foods after the attack has improved.

Outlook (Prognosis)

Most cases go away in a week. However, some cases develop into a life-threatening illness.
The death rate is high with:
• Hemorrhagic pancreatitis
• Liver, heart, or kidney impairment
• Necrotizing pancreatitis

Possible Complications

Pancreatitis can return. The chances of it returning depend on the
cause, and how well it can be treated. Complications of acute
pancreatitis may include:
• Acute kidney failure
• Acute respiratory distress syndrome (ARDS)
• Buildup of fluid in the abdomen (ascites)
• Cysts or abscesses in the pancreas
• Heart failure
• Low blood pressure
Repeat episodes of acute pancreatitis can lead to chronic pancreatitis.

When to Contact a Medical Professional

Prevention

You may lower your risk of new or repeat episodes of pancreatitis by
taking steps to prevent the medical conditions that can lead to the
disease:
• Avoid aspirin when treating a fever in children, especially if they
may have a viral illness, to reduce the risk of Reye syndrome.
• Do NOT drink too much alcohol.
• Make sure children receive vaccines to protect them against mumps and other childhood illnesses.
• Treat medical conditions that contribute to hypertriglyceridemia.

20. Acute respiratory distress syndrome

Acute respiratory distress syndrome (ARDS) is a life-threatening lung
condition that prevents enough oxygen from getting to the lungs and into
the blood. Infants can also have respiratory distress syndrome.

Causes

ARDS can be caused by any major direct or indirect injury to the lung. Common causes include:
• Breathing vomit into the lungs (aspiration)
• Inhaling chemicals
• Lung transplant
• Pneumonia
• Septic shock (infection throughout the body)
• Trauma
ARDS leads to a buildup of fluid in the air sacs (alveoli). This fluid prevents enough oxygen from passing into the bloodstream.
The fluid buildup also makes the lungs heavy and stiff, which decreases
the lungs' ability to expand. The level of oxygen in the blood can stay
dangerously low, even if the person receives oxygen from a breathing
machine (ventilator) through a breathing tube (endotracheal tube).
ARDS often occurs along with the failure of other organ systems, such as
the liver or kidneys. Cigarette smoking and heavy alcohol use may be
risk factors.

Symptoms

Symptoms usually develop within 24 to 48 hours of the injury or illness.
Often, people with ARDS are so sick they cannot complain of symptoms.
Symptoms can include any of the following:
• Difficulty breathing
• Low blood pressure and organ failure
• Rapid breathing
• Shortness of breath

Exams and Tests

Listening to the chest with a stethoscope (auscultation) reveals
abnormal breath sounds, such as crackles, which may be signs of fluid in
the lungs. Often, blood pressure is low. Cyanosis (blue skin, lips, and
nails caused by lack of oxygen to the tissues) is often seen.
Tests used to diagnose ARDS include:
• Arterial blood gas
• Blood tests, including CBC and blood chemistries
• Blood and urine cultures
• Bronchoscopy
• Chest x-ray
• Sputum cultures and analysis
• Tests for possible infections
An echocardiogram or Swan-Ganz catheterization may be needed to rule out
congestive heart failure, which can look similar to ARDS on a chest
x-ray.

Treatment

ARDS often needs to be treated in an intensive care unit (ICU).
The goal of treatment is to provide breathing support and treat the
cause of ARDS. This may involve medicines to treat infections, reduce
inflammation, and remove fluid from the lungs.
A ventilator is used to deliver high doses of oxygen and continued
pressure (positive end-expiratory pressure, or PEEP) to the damaged
lungs. Patients often need to be deeply sedated with medicines. During
treatment, doctors and nurses make every effort to protect the lungs
from further damage.

Support Groups

Many family members of people with ARDS are under extreme stress. Often
they can relieve this stress by joining support groups where members
share common experiences and problems.

Outlook (Prognosis)

About a third of people with ARDS die of the disease. Those who live
usually get back most of their normal lung function, but many people
have permanent (usually mild) lung damage.
Many people who survive ARDS have memory loss or other quality-of-life
problems after they recover. This is due to brain damage that occurred
when the lungs were not working properly and the brain was not getting
enough oxygen.

Possible Complications

• Failure of many organ systems
• Lung damage (such as a collapsed lung--also called pneumothorax) due
to injury from the breathing machine needed to treat the disease
• Pulmonary fibrosis (scarring of the lung)
• Ventilator-associated pneumonia

When to Contact a Medical Professional

Usually, ARDS occurs during another illness, for which the patient is
already in the hospital. In some cases, a healthy person has severe
pneumonia that gets worse and becomes ARDS. If you have trouble
breathing, call your local emergency number (such as 911) or go to the
emergency room.

Published for educational purposes from the website: MedlinePlus Disclaimer: The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.